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Related Concept Videos

The Vestibular System01:29

The Vestibular System

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The vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.
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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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Body:Bioequivalence experimental study designs play a pivotal role in testing the effectiveness of various treatments. Key among these are the repeated measures, cross-over, carry-over, and Latin square designs. In the repeated measures design, each subject receives all treatments, allowing for temporal comparisons. This type of design is useful in reducing variability but requires careful planning to avoid bias.The cross-over design, an economical method, involves sequential administration of...
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Sensory systems detect stimuli—such as light and sound waves—and transduce them into neural signals that can be interpreted by the nervous system. In addition to external stimuli detected by the senses, some sensory systems detect internal stimuli—such as the proprioceptors in muscles and tendons that send feedback about limb position.
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The nucleolus is the most prominent substructure of the nucleus. When it was first discovered, it was considered to be an isolated organelle that forms fibrils and granules. In 1931, the relationship between the nucleolus and chromosomes was first described by Heitz. He observed that the appearance and size of nucleolus varies depending on the stage of the cell cycle. He also noticed constricted regions on different chromosomes clustered together at definite cell cycle stages. These regions,...
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Stereotactic Radiosurgery for Gynecologic Cancer
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Repeat Stereotactic Radiosurgery for Progressive or Recurrent Vestibular Schwannomas.

Christian Iorio-Morin1, Roman Liscak2, Vilibald Vladyka2

  • 1Division of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke, Québec, Canada.

Neurosurgery
|September 7, 2018
PubMed
Summary

Repeat stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) offers high tumor control rates. This approach is safe and effective for managing VS progression after initial SRS treatment.

Keywords:
Gamma knifeRecurrenceStereotactic radiosurgeryVestibular schwannomas

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • Stereotactic radiosurgery (SRS) is a primary treatment for vestibular schwannomas (VS), achieving high long-term control rates.
  • Limited data exist on managing VS progression after initial SRS.

Purpose of the Study:

  • To evaluate the safety and efficacy of a second SRS procedure for patients with VS that progressed after initial SRS.
  • To assess tumor control and clinical outcomes following repeat SRS for VS.

Main Methods:

  • Retrospective analysis of 76 patients from 8 International Gamma Knife Research Foundation (IGKRF) centers.
  • Data included patient and radiosurgery details, clinical symptoms, imaging, and follow-up outcomes.
  • Actuarial analyses were used to determine tumor control rates and clinical evolution.

Main Results:

  • Repeat SRS demonstrated high actuarial tumor control rates: 98.6% at 2 years, 92.2% at 5 years, and 92.2% at 10 years.
  • Useful hearing preservation decreased over time, but 75% of patients reported stable or improved symptoms post-repeat SRS.
  • No cases of radionecrosis, radiation-associated edema, radiation-related neoplasia, or death were attributed to the repeat SRS procedure.

Conclusions:

  • A second SRS procedure is a safe and effective management option for patients with progressing vestibular schwannomas after initial radiosurgery.
  • Repeat SRS can achieve durable tumor control with acceptable toxicity profiles.